Treatment of mild cryptotia by anatomical external auricular muscle transposition without flap transfer: A case...

Cryptotia is a congenital auricular deformity in which the upper helix is buried beneath the temporal skin. Abnormal auricular muscle attachments, particularly of the superior auricular muscle (SAM), are recognized as important in the development this condition. However correction of auricular muscles is not widely considered in conventional cryptotia reconstruction techniques with an emphasis on flap or skin graft cover instead.

We report the successful reconstruction of mild cryptotia in a 35-year-old woman without the use of skin flaps or grafts. Intraoperatively the abnormal SAM and anterior auricular muscle (AAM) were identified under the microscope and corrected by repositioning them their anatomically correct locations behind the conchal bowl and at the base of the helical crus recreating the auriculo cephalic sulcus without the use of skin flaps or grafts. The correction was stable, with no recurrence or functional problems with 3-year follow-up.

Correction of the abnormal auricular muscle attachments should be considered in cryptotia reconstruction. This case highlights the use of auricular muscle repositioning without the use of local flaps to achieve stable, long-term correction of mild cryptotia. This minimally invasive method reduces surgical complexity and may improve patient recovery.